Pediatric Obstructive Sleep Apnea

Abstract. This article review explores the ideas represented by Loghmanee & Sheldon in the article “Pediatric Obstructive Sleep Apnea” published in the Pediatric Annals of 2010. The article argues that the problem of sleep apnea is commonly overlooked and yet it needs to be given medical attention. The article then proceeds to offer some possible solutions for the problem from a medical point of view before considering the way forward on the issue. This review explores the article in sections. The sections of the review include an introduction to the main idea, inferences, a summary, the methodology, considerations for future research and a conclusion. The introduction section gives a brief introduction to the subject of the paper. The inference section presents some of the preliminary conclusions from the research that have a bearing on the management of the problem. The summary section restates the research findings, the research process and the conclusion of the article. The methodology section assesses the suitability of the research methodology for the specific problem outlined in the introduction section. The future research briefly outlines the prospects for research as per the article. The final section, conclusion, gives a final statement on the research.
Pediatric Obstructive Sleep Apnea

1. Main idea. Pediatric obstructive sleep apnea(OSA) in children has emerged as a relatively common condition and also as a disease that imposes a broad range of morbidities, some of which may have long-term effects and even enter into adulthood.

It is characterized by sleep-disordered breathing, which is: snoring and increased upper airway resistance to severe periodic occlusion of the upper airway.

2. Inferences. Obstructive sleep apnea is seen to be a huge problem majorly affecting the children lowering their potential academically, physically and socially. However, as discussed above, there are some remedies to the condition. Parents should therefore occasionally take their children for screening to keep track of their health

3. Summary of the article. One of the most ignored symptoms is snoring. Habitual snoring is defined as audible sonorous noises reported by an observer occurring three or more times a week without evidence of apnea, hypoventilation or significant sleep fragmentation. A Recent study showed that habitual snoring is present in about 7% of children. The study which was done on 6349 parents and children between 5-14 years also revealed that habitual snoring is connected with a poor temper, hyperactivity, cognitive impairment, attention problems and poor school performance. Research by the American Thoracic Society shows that this affects 1-3% of all school-age children CITATION Log10 l 2057 (Loghmanee & Sheldon, 2010).

Snoring has also been correlated with enuresis and elevated blood pressure. This correlation gives enough reason to seek medical examination if one notes the occurrence of habitual snoring. It is also key to ensuring that medical aid is sought from legally trained accredited doctors. It is also key that
Primary care providers to screen regularly for snoring during routine health maintenance visits.

Given that sleep disorders in children are not easily noted screening tools that make it easier to identify the disorders have been developed. This development should, therefore, be an encouragement to parents to take their children for a checkup since these advancements have simplified the process.

It may be difficult to differentiate habitual sleeping from OSA basing on clinical history and examination alone. Therefore, polysomnography (the gold standard for diagnosing and quantifying OSA has to be used). Unfortunately, there is a limited number of pediatric sleep medicine centers and specialists which may lead to delays in comprehensive pediatric sleep medicine evaluations. A recent study on Chinese children with mild OSA who were not treated showed that 29% had a more severe condition. Risk factors for worsening OSA include large tonsils at baseline, male gender, and younger age CITATION Log10 l 2057 (Loghmanee & Sheldon, 2010). Although the studies were not that comprehensive, evidence suggests that OSA does not consistently improve over time and may even worsen in some cases. This finding, therefore, implies that careful evaluation of any snoring patient must be done as soon as possible and treatment based on some underlying etiology provided to avoid comorbidities associated with the spectrum of pediatric OSA.
Adenotonsillectomy is one of the ways of treatment remedies to OSA. The most common indication for this is obstruction of the upper airway. However, study shows that its treatment is complicated to some extent but improves sleep and behavior in children. It also enhances the quality of life. After any adenotonsillectomy process, it’s important that children undergo Postoperative(PSG) to ensure that those with pediatric OSA receive appropriate care.

Another approach to remedy the condition is the use of anti-inflammatory medications. Studies suggest that nasal steroids and leukotriene antagonists might be considered either as an adjunct to or in place of adenotonsillectomy in the treatment of OSA.

Another method is the non-surgical airway expansion. This intervention is for children to whom surgery is either ineffective or contraindicated. The most well known in adults is the bilevel positive airway pressure(PAP). It is, however, difficult for children to tolerate mask and airflow. It should also be noted that obese children are at high risk to develop OSA than non-obese ones.

4. Methodology. Regarding the methodology used to obtain the data, is my view that further research should be done to get more accurate data. Research should be done on a broader scope rather than concentrating on specific regions.

5. Recommended future research. To find better solutions, it would be wise for more research to be done concerning OSA to find better ways of handling the condition.

6. Conclusion. In conclusion, it should be noted that OSA is a threatening disease that may make their childhood lives not as fun as they should be. Prior precautions should, therefore, be taken by parents to ensure their children are safe.

7. References

BIBLIOGRAPHY Loghmanee, D. A., & Sheldon, S. H. (2010). Pediatric Obstructive Sleep Apnea. Pediatric Annals, 39(12), 784-791.